CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: City of Hope National Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $479
Cash Discount Price: $625
vs. Medicare Baseline: 3.05x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at City of Hope National Medical Center is $479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.05x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$625

Average discount available for prompt cash payment at this facility.

Insurance Median

$479

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)

Cash / Self-Pay: $625 (398%)

Insurance Median: $479 (305%)

Cash: $625 (398% of Medicare)

Ins. Median: $479 (305% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 305% of the Medicare baseline (a markup of 205%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Health Net	$75 - $606	48%
Cal Optima	$105 - $144	67%
Heritage Provider Network	$135 - $438	86%
Inland Empire	$161 - $500	103%
Prime Healthcare Keenan	$226 - $600	144%
Blue Cross Blue Shield	$312 - $1,010	199%
UnitedHealthcare	$350 - $479	223%
Blue Shield	$370 - $745	236%
Blue Shield Covca	$380	242%
Blue Shield Promise	$438	279%
Cencal	$500	319%
La Care Health	$500	319%
Kaiser	$562	358%
Cigna	$615	392%
Aetna	$625	398%
Gold Coast	$625	398%
Molina	$625 - $812	398%
Facey	$688	438%
Healthcare Partners	$725	462%
St. Joseph Heritage	$750	478%
Primecare Medical Network	$812	517%
First Health	$962	613%
Phcs Multiplan	$1,125	717%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $625.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm City of Hope National Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.